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One morning in a village in Orissa, people awoke to the sight of a giant fake tooth propped up in an empty field.

Standing in front of it were two teams of “contestants” drawn from the village – one, with red and white shields, were to protect the tooth, while the other pelted it with white balls.

It was a game designed by marketers, betting that the red-and-white colours would remind villagers of Colgate – the first multinational brand to urge Indians to adopt its toothbrushes and toothpaste, pushing aside the traditional twigs and ash.

The skirmish ended with a group photograph, eventually enlarged into a billboard announcing: “This village is Calci-Locked!” The smiles masked a steely, silent message: No Trespassing on Colgate Turf.

Tussling over market share can be a colourful business in India’s fiercely competitive toothpaste arena. Fickle consumers and outlandish claims keep the drama alive.

“All dental problems have been solved with this, you need not go to the dentist,” says a Bangalore salesman for Dant Kanti, the herbal toothpaste made by Patanjali Ayurved, a company led by TV yoga guru Baba Ramdev.

Some are not amused. Patanjali faces a lawsuit in Rajasthan for asserting that Indian patriots should choose its toothpaste.

But its tactics and the onslaught of brands including Dabur Red, Close-Up, Sensodyne, Pepsodent, Himalaya, and Glister (the stealth Amway contender) often obscure a very basic fact.

On a global scale, India’s per-capita use of toothpaste remains “pathetically low”, as one industry insider said.

Euromonitor International says Indians use just a quarter of the toothpaste used per capita in Brazil and just half of that in China.

Frugal Indian brushers tend to skimp. Urban per capita toothpaste use is 270 grams, compared with 85 grams in rural areas, according to Nielsen India. At least 250 million people in India don’t use toothpaste at all, says the Rural Marketing Association of India.

That scope for growth makes India an especially tempting morsel for global and local toothpaste barons. Investors wonder whether Colgate can shield its formidable 54 per cent market share.

Yet the real public health question lies in whether all brands together can slow down tooth decay and gum disease in India.

Changing diets, including a sugary biscuit-and-ice cream invasion of the smallest hamlets, magnify the risks.

So does poverty. Only 4 per cent of the population visits a dentist in any given year.

Meanwhile, two thirds of qualified dentists choose not to practise at all, the Indian Dental Association says. That is because of the high costs of setting up a solo practice, combined with family demands on female graduates.

Fewer than 20 per cent of the country’s 125,000 practising dentists work in rural areas.

But not everyone agrees that modern India requires toothbrush and toothpaste, let alone a regular preventive trip to the dentist.

Stand outside the blue gate at the Alliance Jute Mill in Jagatdal, West Bengal. This industrial stretch draws workers from rural Bihar.

At 5pm, at the end of their shift, workers crowd around 75-year-old Upinder, another Bihari, who chops a pile of neem and sells seven twigs for 3 rupees. The ayurvedic custom of chewing a frayed neem twig to clean the teeth has survived in India for thousands of years.

Upinder reports that sales are declining. “The new generation loves Colgate,” he says, having migrated here in the 1970s. “In four years, I will go out of business.”

Maybe not. It’s easy to discern the staying power of neem in certain corners of rural India.

“Have you noticed that guys like to walk around the village and chew on twigs? You can’t do that with a mouthful of foam,” says Rimi Chatterjee, an English professor in Kolkata. Like the proverbial toothpick, the twig accords an element of style.

Prof Chatterjee also points to devotional songs and stories. “Radha will flirt with Krishna by inviting him to clean his teeth,” she recounts, tempting him with twigs and salt.

Elsewhere, families prefer ash made from rice husks, cow dung or other ingredients. Applied with a finger, it is used for teeth and a lingering gum massage.

This is why some Indians have made a natural transition to tooth powder such as Dabur’s Lal Dant Manjan.

The Indian Dental Association criticises twig and ash for abrasive elements that endanger tooth enamel.

As for children, they may be easy to motivate in schools but some parents just cannot cope with the expense.

“Poverty, illiteracy, ignorance,” rattles off a Colgate executive. “Dental care is the last priority. They buy salt. They don’t want to spend more money.”

So far, rural areas account for just 35 per cent of Colgate’s revenues in India.

Chasing profits relies on converting users from small 10-rupee tubes to large family-size ones. Those can provide margins of between 45 and 50 per cent, says George Angelo, Dabur’s former executive sales director.

In the past, Dabur agents tried to drive home a message far less glamorous than the current crop of celebrity TV endorsements.

“If you have a dental problem, you can’t work in the fields and won’t be able to generate a daily wage,” says Mr Angelo. “Your family will go hungry.”

Many personal care products are involved in the craze for rural marketing by mobile phone. But most analysts argue that such low-cost remote contacts should only sustain an engagement made face-to-face.

Marketing teams are therefore still scurrying around India, holding events like magic shows, quizzes, giveaways at religious gatherings and handing out samples in railway cars.

“They want someone to explain what it is, how it works and what are the benefits,” says Abhishek A, an assistant professor of marketing at the Indian Institute of Management in Ahmedabad (IIMA).

Rather than challenge rural trust in traditional hygiene practices, brands such as Colgate are redoubling efforts to promote classic elements such as salt, neem and charcoal in their products.

Toothpaste highlights the vital role of city travel and migration in product adoption in rural India. “The products that are more urban in nature will be accepted in villages faster than before,” says Piyush Sinha, an IIMA retailing professor who recently studied purchasing decisions by 6,000 people in 35 rural districts.

Village elders are no longer deemed the most crucial opinion leaders.

It is the cousin sailing on a Caribbean cruise ship, the sister in London or the brother working in Abu Dhabi, who are emerging as key taste-makers for loved ones back home.

Global advertising – not just local – may prove important in India’s toothpaste wars.